Bone Temperature Variation Using a 3D-Printed Surgical Guide with Internal Irrigation

Abstract

Bone overheating is a possible cause of implants early failure. When a surgical guide is used, the risk of heat injury is greater due to the reduced efficacy of the irrigation. The aim of this ex vivo study was to evaluate the effect of an additional built-in irrigation on bone temperature variation during implant osteotomy. Twelve bovine ribs were used. Cone beam computerized tomography (CBCT) was performed and a 3D-printed surgical guide with additional built-in irrigation tubes was produced for each rib. A total of 48 osteotomies were prepared, to compare the supplementary internal irrigation system (Group A) with external irrigation alone (Group B), no irrigation (Group C) and with free-hand surgery with external irrigation (Group D). Temperature was measured by three thermocouples placed at depths of 1.5, 7, and 12 mm. The largest temperature variation at each thermocouple showed median values of 3.0 °C, 1.9 °C, and 2.3 °C in Group 1; 2.3 °C, 1.7 °C, and 0.9 °C in Group 2; 3.2 °C, 1.6 °C, and 2.0 °C in Group 3; 2.0 °C, 2.0 °C, and 1.3 °C in Group 4, respectively. No differences were found among the four groups. In general, the highest temperature increase was observed with the use of the first drill (cortical perforator). Post-experimental CBCT revealed the presence of radiopaque material clogging the aperture of the internal irrigation channels. Additional internal irrigation was not found to significantly contribute to decrease bone temperature in this ex vivo setting.